[Allen Ali Nasseh]

Dr. Nasseh introduces a new application of bioceramics in using BC Temp, a bioceramic that will not set but will gradually release Ca(OH)2 for long te
[See the full post at: BC Temp for Ca(OH)2 intra canal dressing (CBL 38)]

[Larry Loewen]

Is the BC Temp just in the canals? What’s in the pulp chamber area and what temporary filling is placed while waiting the 3 months for healing? Can a lentulo spiral be used to get the BC Temp down the full length of the canal or should a different method be used?

[Larry Loewen]

What’s the reason for waiting 3 months as opposed to 1 or 2 months?

[Allen Ali Nasseh]

@Larry Loewen: That’s a great question! If you have a continued release of Ca(OH)2 over a longer time period, your odds of penetrating deeper into the dentinal tubules and slowly breaking down the biofilm, especially in more resistant species is higher. It’s like using a bacteriostatic medication for longer time period. Also, E. recalls, is resistant to Ca(OH)2 as it has a calcium pump that throws off the calcium. But over longer time periods this will be disabled and the bug will eventually be killed. Also, for cases of apexification or other factors where you need to wait for asteoid formation the longer term is needed. But for the run of the mill necrotic canal, why 3 or 6months vs. 1 or 2 months is probably better answered by Dr. Ricucci who is the proponent of longer term therapy. I will try to ask him that question and will hopefully get back to you if he answers. 🙂
Cheers,
Ali

[Larry Loewen]

2nd request Is the BC Temp just in the canals? What’s in the pulp chamber area and what temporary filling is placed while waiting the 3 months for healing? Can a lentulo spiral be used to get the BC Temp down the full length of the canal or should a different method be used?

[Allen Ali Nasseh]

@Larry Loewen: Forgot the second part. Yes, BC Temp inside the canal only (not outside) and a lentulo or file can be used to place to apex. Then follow with either cotton/cavit for shorter term provisional (less than 1month) and Teflon Tape/BC Liner for longer term provisionalization (Longer than 1month).

[Larry Loewen]

Thank you.
I’m enjoying your videos.

[Jason Wu]

Hi Dr. Nasseh,
I have a question regarding external root resorption. I’ve read that calcium hydroxide is sometimes used to arrest the resorptive cells. Would you do the same with BC Temp? If so, how long would you leave it in for? Or do you think trying to remove the resorption and placing TCA with BC putty will work better?
Thanks,
Jason

[Allen Ali Nasseh]

@Jason Wu: That’s a very good question. I don’t think there are any studies directly comparing Ca(OH)2 with TCA for resorptive defect repairs. I think TCA is much more aggressive than Ca(OH)2 in causing necrosis for the resorptive cells. Ca(OH)2 causes a think layer of tissue necrosis. So, I would use Ca(OH)2 for internal resorption that has perforated (direct contact necrosis only) but would use TCA for External resorption that has spread inside the tooth (requiring deeper reach). Cheers! 🙂

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